American Journal of Nursing Research
ISSN (Print): 2378-5594 ISSN (Online): 2378-5586 Website: Editor-in-chief: Apply for this position
Open Access
Journal Browser
American Journal of Nursing Research. 2018, 6(5), 229-236
DOI: 10.12691/ajnr-6-5-3
Open AccessArticle

The Barriers to Health Promotion Activities through Perception of Women with Chronic Disease

Omaima Mohamed Elalem1, , Magda Aly Mohamed1 and Soheir Tawfeek Ahamed2

1Community & Family Health Nursing Department, Faculty of Nursing, Port-said University, Egypt

2Medical Surgical Nursing Department, Faculty of Nursing/ Ain Shams University, Egypt

Pub. Date: June 21, 2018

Cite this paper:
Omaima Mohamed Elalem, Magda Aly Mohamed and Soheir Tawfeek Ahamed. The Barriers to Health Promotion Activities through Perception of Women with Chronic Disease. American Journal of Nursing Research. 2018; 6(5):229-236. doi: 10.12691/ajnr-6-5-3


Background: One of the greatest challenges that will face health systems globally in the twenty-first century will be the increasing burden of chronic diseases. Chronic diseases are one of the most important barriers that have a direct and negative impact on health promotion for women. Aim of this study was to identify the barriers to health promotion activities for women with chronic disease. Subjects and methods: A cross-sectional study design was utilized to achieve the aim of the current study. Setting: This study was conducted in primary health care centers and outpatient clinics of governmental hospital located in Port-Said City. Subjects: Purposive samples of 744 adult women who surfing from chronic disease. Tools of data collections: two tools were used to collect data. Tool I: A structured questionnaire sheet. Tool II: Barriers to Health Promoting Activities for Disabled Persons Scale (BHADP) obesity was determined based on body mass index (BMI). Results the majority (79.4%) of the study sample had high level barrier of health promotion. the five highest leading barriers items were: Embarrassment about my appearance; Lack of support from family, friends; Lack of help from health care professionals; Bad weather and; No one to help. 38.6%) of women who have a high score of levels of Health Promotion Barriers' suffering of Diabetes Mellitus. There was a strong significant correlation between the levels of Health Promotion Barriers' and body mass index, level of education and duration of chronic disease with p-value ≤ 0.001. This study concludes that women with chronic diseases had a high score of health promotion barrier. The study recommends a greater emphasis on assessing and managing perceived barriers to health promotion activities in health education and policy development and proposes a conceptual model for understanding perceived barriers to action.

Barriers to Health Promotion Chronic Disease Factors

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  WHO. 2002 Innovative care for chronic conditions: building blocks for action. Geneva: World Health Organization; accessed 27 January 2018.
[2]  Quality of Life in Chronic Disease Patients. Kalliopi Megari Author information Articl Health Psychol Res. 2013 Sep 24; 1(3): e27. Published online 2013 Sep 23.
[3]  Medicine 2018) Medical Definition of Chronic disease. accessed 27 January 2018.
[4]  World health organization (2017) Eastern Mediterranean Region Framework for health information systems and core indicators for monitoring health situation and health system performance Country statistical profiles. CC BY-NC-SA 3.0 IGO licence. accessed 12 January 2018).
[5]  Global health estimates 2014 summary tables: Estimated deaths by cause, sex and WHO Member State 2012. Geneva: World Health Organization; 2014, accessed 12 January 2018.
[6]  Abbott, P., Davison, J., Moore, L., & Rubintein, R. (2010). Barriers and enhancers to dietary behaviour change for Aboriginal people attending a diabetes cooking course. Health Promotion Journal of Australia, 21(1).
[7]  Schmidt H. (2016): Chronic disease prevention and health promotion. NCBI Bookshelf. University of Pennsylvania, Philadelphia, PA, USA. April 13, 2016.
[8]  American Heart Association. (2013). Herat disease and stroke statistics-
[9]  Chew L, Cheah C, Koh YH. Health promotion program in the private workplaces in Singapore: a prevalence survey. Singapore Med J 2002; 43: 18-24.
[10]  Kroneman M, Boerma W, van den Berg M, Groenewegen P, de Jong J, van Ginneken E (2016). The Netherlands: health system review. Health Systems in Transition, 2016; 18(2):1-239.
[11]  Daly G (2004). How a health promotion model reduces disabling complications of diabetes at diabetes/199689. article accessed 12 January 2018).
[12]  El Nouman A., El Derwi D., Abdel Hai R. and Abou Zeina H. (2009). Female youth health promotion model in primary health care: a community-based study in rural Upper Egypt. Eastern Mediterranean Health. Journal Department of Public Health and Community Medicine, Faculty of Medicine, University of Cairo, Cairo, EMHJ, 2009, 15(6):1513-1524.
[13]  Kronfol N.M. Access and barriers to health care delivery in Arab countries: a review Eastern Mediterranean Health Journal. Lebanese Health Care Management Association, Beirut, Lebanon. EMHJ, 2012, 18(12):1239-1246.
[14]  Stanton W, Balanda K, Gillespie A & Lowe J. Barriers to health promotion activities in public hospitals Article in Australian and New Zealand Journal of Public Health 20 (5): 500-4 November 2002.
[15]  Strömberg A., Mårtensson J., Fridlund B., Levin L. Å., Karlsson J. E., Dahlström U.. Nurse-led heart failure clinics improve survival and self-care behavior in patients with heart failure. Results from a prospective, randomised trial, European Heart Journal, 2003, vol. 24 (pg. 1014-1023).
[16]  Griffiths C., Miles K., Aldam D., Cornforth D., Milton J., Edwards S., Williams I., A nurse- and pharmacist-led treatment advice clinic for patients attending an HIV outpatient clinic, Journal of Advanced Nursing, 2007, vol. 58 (pg. 320-326).
[17]  Bosch-Capblanc X., Abba K., Prictor M., Garner P.. Contracts between patients and healthcare practitioners for improving patients' adherence to treatment, prevention and health promotion activities, The Cochrane Database of Systematic Reviews, 2009, vol. 2007 (pg. 1-73) The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
[18]  Keleher H., Parker R., Abdulwadud O., Francis K. (2009). Systematic review of the effectiveness of primary care nursing, International Journal of Nursing Practice , 2009, vol. 15 (pg. 16-24).
[19]  WHO. Obesity. Preventing and managing the global epidemic. (1998) Report of WHO Consuitation on Obesity, Geneva, World Health Organization, 1998.
[20]  Becker, H. & Stuifbergen, A.K. (2004). What makes it so hard? Barriers to health promotion experienced by people with multiple sclerosis and polio. Family and Community Health 27(1), 75-83.
[21]  Bird, S., Radermacher, H., Feldman, S., Sims, J., Kurowski, W., Brownings, C., (2009). Factors influencing the phys-ical activity levels of older people from culturally diverse communities: An Australian experience. Ageing & Society, 29, 1275-1294.
[22]  Crane, P. B., & McSweeney, J. C. (2003). Exploring older women’s lifestyle changes after myocardial infarction. Medsurg Nursing: Official Journal of The Academy of Medical-Surgical Nurses, 12(3), 170-176.
[23]  Newson, R. S., & Kemps, E. B. (2007). Factors that promote and prevent exercise engagement in older adults. Journal of Aging and Health, 19(3), 470-481.
[24]  Wilcox, S., Oberrecht, L., Bopp, M., Kammermann, S. K., & McEl-murray, C. T. (2005). A qualitative study of exercise in older African American and white women in rural South Carolina: Perceptions, barriers, and motivations. Journal of Women & Aging, 17(1-2), 37-53.
[25]  Bowen, D. J., Balsam, K. F., Diergaarde, B., Russo, M., & Escamilla, G. M. (2006). Healthy eating, exercise, and weight: Impressions of sexual minority women. Women & Health, 44(1), 79-93.
[26]  Juarbe, T., Turok, X. P., & Perez-Stable, E. J. (2002). Perceived benefits and barriers to physical activity among older Latina women. Western Journal of Nursing Research, 24(8), 868-886.
[27]  Osuji, T., Lovegreen, S. L., Elliott, M., & Brownson, R. C. (2006). Barriers to physical activity among women in the rural midwest. Women & Health, 44(1), 41-55.
[28]  Ansari, W. E., & Lovell, G. (2009). Barriers to exercise in younger and older non-exercising adult women: A cross sectional study in Lon-don, United Kingdom. International Journal Of Environmental Research And Public Health, 6, 1443-1455.
[29]  Smith M., Ory M., Ahn S., and Miles T. (2013). Factors associated with women’s chronic disease management: Associates of healthcare frustrations, physician support and self-care needs. J Aging Res. Oct.; 2.
[30]  McGuire, Amanda Mary (2011). Factors influencing health promotion activities in midlife and older Australian women with a chronic disease. Masters by Research thesis, Queensland University of Technology.
[31]  Vogeli C., Shields AE., & Lee TA, et al. Multiple chronic conditions: prevalence, health consequences, and implications for quality care management, and costs. Journal of General Internal Medicine.2007; 22(3):391-395.
[32]  Perry, C. K., Rosenfeld, A. G., & Kendall, J. (2008). Rural women walking for health. Western Journal of Nursing Research, 30(3), 295-316.
[33]  Kharicha, K., Iliffe, S., Harari, D., Swift, C., Gillman, G., & Stuck, A. E. (2007, April). Health risk appraisal in older people 1: Are older people living alone an ‘at risk’ group? British Journal of General Practice, 271-276.